CPT® Code 45388

Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)

A flexible colonoscopy is a diagnostic and therapeutic procedure that involves the use of a flexible colonoscope to visualize the interior of the colon and rectum. During this procedure, the colonoscope, which is a long, flexible tube equipped with a camera and light source, is inserted into the rectum and advanced through the entire colon to the cecum or the terminal ileum. The use of air insufflation is critical as it helps to expand the colon, allowing for better visualization of the mucosal surfaces by separating the folds of the colon. This enhanced view is essential for identifying any abnormal growths such as tumors, polyps, or other lesions that may require treatment. Once the lesions are identified, the procedure may involve the ablation of these growths. Ablation refers to the removal or destruction of tissue, and in this context, it is performed using a laser device that is introduced through the colonoscope. Prior to the ablation, if there are strictures or narrowed areas in the colon that may hinder access to the lesions, dilation may be necessary. This is achieved by inserting a guidewire through the colonoscope, followed by the passage of a series of rigid tubes or a balloon catheter to widen the lumen of the colon. The ablation process itself involves carefully targeting the lesions with the laser as the endoscope is retracted, ensuring that the entire lesion is destroyed. This procedure is repeated as necessary until all identified lesions have been effectively treated. After the ablation, the colon is re-examined to confirm that all lesions have been successfully destroyed and to check for any potential injuries that may have occurred during the procedure. This comprehensive approach ensures both the effective treatment of abnormal growths and the safety of the patient throughout the process.